Isoperistaltic versus Antiperistaltic Ileocolic Anastomosis in Right Sided Colon Cancer Patients Undergoing Right Hemicolectomy

Abstract

Background: Colorectal cancer is the third most common but second most deadly cancer, with a 4-fold higher incidence rate in transitioning countries, accounting for one in every ten cases and fatalities. Aim: to compare between isoperistaltic and anti-peristaltic anastomosis in terms of pre-operative, operational and anastomotic time, postoperative morbidity, and mortality within 30 days post-op. Methods: This randomized interventional study took place in the Surgical Oncology Unit, Suez Canal University hospitals. Sixty-two Patients with right-sided colon cancer who were elected for open right hemicolectomy were randomly recruited into two groups: Group A: people undergoing isoperistaltic ileocolic anastomosis and group B: people undergoing anti-peristaltic ileocolic anastomosis. Results: A total sample of 62 patients with a mean age of 55 ± 11.05 years. No significant difference between the two groups regarding anastomotic time and tumor location. There were 38.7% classified as stage I and 61.3% classified as stage II. Adenocarcinoma represented about 95.2% in the participants. The two studied groups did not show any significant difference regarding operative time, estimated blood loss, length of hospital stay, complications, reoperation and bowel obstruction. Days for first flatus and stool did not show any significant difference between the two studied groups. While satisfactory oral tolerance was significantly longer among ISO group. Gastro-Intestinal-Quality-Of-Life questionnaire scores pre and post-operative (1 month) did not show any significant difference between the two studied groups. Conclusion: no difference between Isoperistaltic and Antiperistaltic Ileocolic Anastomosis in Right-Sided Colon Cancer in terms of operative and postoperative complications.